Provider Demographics
NPI:1285786343
Name:ZITO, CHRISTOPHER D (MD, FCCP, INC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:D
Last Name:ZITO
Suffix:
Gender:M
Credentials:MD, FCCP, INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14860 ROSCOE BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4665
Mailing Address - Country:US
Mailing Address - Phone:818-376-4074
Mailing Address - Fax:818-376-4082
Practice Address - Street 1:14860 ROSCOE BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4665
Practice Address - Country:US
Practice Address - Phone:818-376-4074
Practice Address - Fax:818-376-4082
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41142174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G411420Medicaid
CAB56896Medicare UPIN
CAG41142Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER